Avoiding Facial Volume Loss from Laser/ Radiofrequency Treatments, and Procedures They Can't Replace

More on laser and radiofrequency treatments: prasadcosmetic...
For more on platelet-rich plasma (PRP), please go to:
prasadcosmetic...
For more on Structural Volumizing, please go to: prasadcosmetic...
To learn more about Dr. Prasad's background and training, please got to: prasadcosmetic...
New York oculoplastic and reconstructive surgeon Amiya Prasad, M.D. reviews why laser and radiofrequency thermal treatments can cause facial volume loss when used inappropriately; how facial volume loss is avoided in treatment; the different ways skin quality, texture, and volume loss can be addressed effectively without damage to the skin; and the limits of thermal energy treatments in replacing surgical procedures:
0:23 - Introduction to laser and radiofrequency treatment
0:36 - How laser and radiofrequency treatments are not substitutes for surgery
1:23 - How unlicensed practitioners can perform laser treatment in the state of New York and other places
2:03 - Dr. Prasad details his background training in cosmetic oculofacial plastic and reconstructive surgery, as well as his experience as a facial rejuvenation specialist
2:32 - How chemical peels addressed wrinkles and skin texture before CO2 lasers
3:02 - The benefit of CO2 lasers over chemical peels
3:13 - How laser treatments improve skin quality
3:35 - How facial aging is associated more with bone loss and weakening of facial tissues
4:24 - Why surgical lifting or thermal energy treatments are not ideal for volume correction
4:44 - How volume loss is best addressed with the help of fillers
4:58 - Traditional filler placement versus the Structural Volumizing technique
5:39 - How Structural Volumizing addresses volume loss more effectively at the bone level
6:10 - Why a facelift and neck lift is more suited for patients in their 50s who have sagging of the SMAS and soft tissue
6:50 - How Dr. Prasad performs facelifting procedures in his practice
7:21 - Aggressive use of laser devices often leaves the patients with more complications
8:01 - Disadvantages of prolonged heat exposure from thermal energy devices
8:29 - Important points to consider when deciding on which laser treatment to undergo
9:08 - The different lasers Dr. Prasad uses in his practice
9:37 - The importance of considering a patient’s capacity to produce collagen in their skin
10:24 - Factors that affect a patient’s capacity to produce collagen in their skin
10:52 - The benefit of combining treatment modalities to achieve optimum results
11:30 - The role of platelet-rich plasma and hyaluronic acid in improving skin quality.
12:00 - Conclusion and Dr. Prasad’s recommendation
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[@arymhansie]

You are such a brilliant doctor, you take all the time to explain things at great length. I hope to see you some day!

[@AmiyaPrasadMD]

Thank you for the kind words, arym hansie! Glad you find the videos helpful!

[@sadafkhan1858]

I just love how he answers questions and bring forth the necessary information without unnecessary talk specially how calm humble and informative his approach and tone is . That’s what made me subscribe immediately.

[@AmiyaPrasadMD]

Thank you for your kind words, Sadaf Khan! And thanks for watching, and subscribing!

[@sonianoir5766]

Finally a DR who tells it like it is. I knew purely from observation, many years ago, that thermal was creating a gaunt look on patients and some fat loss a few months later. Wish you were in California! Thank you.

[@AmiyaPrasadMD]

Thank you, Sonia Noir!

[@melt7891]

And Australia!

[@dammar117]

Also, be careful of at home devices. I've been using one for a few months and I now notice accelerated sagging.

[@AmiyaPrasadMD]

Hi dam mar, Sorry to hear about your problem. I do agree with you as the problem with home devices is the lack of training for the user, who tends to over treat themselves when they don't notice results. Also, many device manufacturers don't give clear instructions on safe use of their devices, but many of these manufacturers also don't have the proper training to say what is proper use of their own devices. This more recent video may help you in skin rehabilitation from your home device - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@geminiflower]

What was the device?

[@lifewithkhiz]

Is that nuface??

[@LS-hu1lm]

Love the video music and production values from the 90s and the Dr's information from 10 years in the future. If I visit NY I definitely want to come see you!

[@AmiyaPrasadMD]

Thank you for your kind words, LS F! I'm really happy you like the videos! Come see us any time!

[@adriaticseaeyes]

WOW! so timely here for me in 2021 when I was contemplating a laser package for my acne scarring...thank you Dr. Prasad

[@AmiyaPrasadMD]

Hi adriaticseaeyes, Laser treatment can still be beneficial for treating acne scars, but you will likely need more than one mode of treatment for best results. Also, offering a package may be good, although it's not clear if there are other treatments involved, as acne scars do require several treatment sessions before improvement is seen. You can refer to these videos about why a treatment plan is needed to treat acne scars: kzbin.info/www/bejne/Z3Ksg4SYftqDqK8 kzbin.info/www/bejne/r4u5dKt_hMmpp5o

[@Kathrynh246]

This was EXCELLENT Dr. Prasad!! xoxoxo!!!

[@AmiyaPrasadMD]

Thanks again, KathysBeautyCareChats! I appreciate your continued viewership!

[@AmiyaPrasadMD]

Thank you for your kind words,@Joe Gillis!

[@lyndabustillos5209]

Dr. Prasad, what an awesomely honest, informative, and well articulated video! Thank you:)

[@AmiyaPrasadMD]

Thank you for your kind words, Lynda Bustillos! I'm glad the video helped you :)

[@martha2004]

“Find a Dr. you can trust”, hard to do so. You sound like an honest Dr. I wish you were in Canada. I am done some procedures and the results are worse, so I give up, and I believe all they done is steal my money. Now I will only do facials like Oxygene. Thanks

[@AmiyaPrasadMD]

Hi martha borges, Sorry to hear about your past experiences. If you are in Eastern Canada near the border, we are not far for you to travel to see us. I hope this helps you.

[@dammar117]

I am in Canada and went to get treated by Dr Prasad. Totally worth it. He did a superb job on my eyebags, and I am considering going back to him for structural volumizing once covid is over. Will not go to anyone else. Travel time, bank loan... totally worth it.

[@AmiyaPrasadMD]

Thank you for your kind words, @@dammar117! Hope to see you again soon! We are expecting to reopen this month, as soon as the State lifts the temporary ban on elective surgeries.

[@janeharman9670]

Great explanation and advice 👏🏻 So honest and professional. I would love to have a consultation with you Dr Prasad. So bad you aren’t he in LA.

[@AmiyaPrasadMD]

Thank you for your kind words, Jane Harman! And thanks for watching! Please contact us if you'd like a virtual consultation over Skype or FaceTime.

[@hamiam100]

Thank you for the advice. And your skin Doctor is beautiful

[@AmiyaPrasadMD]

You're welcome, james lynn ham! And thank you for the compliment!

[@pulgini1002]

Dr. Prasad is fabulous!!

[@AmiyaPrasadMD]

Thank you for your kind words, pulgini1002!

[@dianne90277]

I had CO2 laser damage that can’t be repaired- hypo pigmentation, volume loss, laxity and more wrinkles. Wish I had watched this beforehand

[@AmiyaPrasadMD]

Sorry to hear about that, Diane Greer. I did make a more recent video than this one about possible treatment of damage after aggressive thermal treatments - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@TwinMillMC]

Ultherapy is one that has very bad volume loss results also.

[@AmiyaPrasadMD]

Hi TwinMillMC, You are absolutely right, but I didn't feature ultherapy here as I don't use it in my practice, mainly because it heats up very quickly, and temperature is difficult to regulate with it to prevent overexposure and overheating.

[@larabardot6836]

Dear Dr. Prasad, I’ve had an Aerolase Neo treatment done on my whole face 2 weeks ago for my acne scars and rejuvenation. My treatment was pretty fast, there was barely any pain, no downtime and no redness or any side effects afterwards other than a nicer skin tone. My biggest concern is that I found out too late that it’s essentially an IPL type of laser and I’ve read some horror stories online about it. There’s several reviews claiming it caused them premature aging, facial fat loss, rash etc. The worst part is that they’re saying that the damage starts showing 3 weeks to 3 months after which makes me really anxious and scared. Do you think I have a reason to be concerned considering I only had one treatment? Thank you in advance!

[@AmiyaPrasadMD]

Hi Lara Bardot, Damage from laser treatment usually occurs when a patient insists on a lifting effect to avoid surgery, so treatment gets more aggressive with higher temperature, and prolonged exposure. It doesn't sound like this is what happened to you as treating acne scars is not as aggressive as trying to get a non-surgical facelift. You can review this video about how laser treatment can be done more safely with the doctor's skill and experience - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@thisisaname4661]

If you look up the topic of laser resurfacing and facial fat loss on Real Self most surgeons will say that it does NOT cause fat atrophy. Why is this?

[@AmiyaPrasadMD]

Hi Jessica Postopoly, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. Complications from laser treatments are most often due to the patient insisting on a lifting effect from the laser treatment so they can avoid surgery, so it's important to have reasonable expectations from the treatment to not risk these complications. I hope this clarifies things for you.

[@user-br3vj6qn7l]

Because many doctors only think in money, they dont say the truth obviuosly. I also reaad all those opinions of doctors saying that lasers cant cause fat loss an they are safe... SHAME!!!

[@melt7891]

Thankyou so much. Your videos are so important.

[@AmiyaPrasadMD]

You're welcome, Mel T! I'm glad the video helped you. Thanks again for watching!

[@SparkingLife111]

So a rf device can help stimulate collagen but due to heat also causes fat loss? Also makes me question how heat causes fat loss bc if so than putting a heating pad on my hips should cause fat loss. Or is it the combination of heat and rf that causes fat loss.

[@AmiyaPrasadMD]

Hi sparkinglife 111, Laser and RF devices don't have to cause fat loss if they are used appropriately with limited exposure and heat. Laser and RF devices are much hotter and more concentrated than a heating pad, so a heating pad will not cause fat loss. I hope this clarifies things for you.

[@justinajones3000]

@@AmiyaPrasadMD Excellent response.

[@AmiyaPrasadMD]

Thanks @@justinajones3000!

[@user-uj6sc7ls9y]

@@AmiyaPrasadMD What about home RF treatments? The machines are much weaker than professional ones. Are they strong enough to cause loss of facial volume? (Are they strong enough to do anything?)

[@AmiyaPrasadMD]

Hi@@user-uj6sc7ls9y, The problem with home radiofrequency treatments, even if they are not as intense as professional devices, is that users aren't trained to use them. Keep in mind that volume loss is not caused by professional devices, but rather the practitioner using them. The same principle applies to home based devices, but with even less training and experience using them. I hope this clarifies things for you.

[@src3360]

I was an RN/esthetician at a medspa and helped with consults and I always stressed that nothing replaces a surgical procedure, NOTHING. What if I do 10 Ultherapy treatments and 10000 threads, will it make my neck look 16 again??? No, no it wont.... But a neck lift would make it look 35 again!!!!

[@AmiyaPrasadMD]

Hi SRC, Thank you for your professional insight! Trying to replace surgical lifting procedures with lasers does lead to many avoidable complications. I actually don't perform threadlifts at all since they only lift the skin, and do not treat the underlying tissue and muscle foundation. I did make a video specifically about why lasers can't replace a surgical lifting procedure to try to educate people about it - kzbin.info/www/bejne/kGbPqWZvYshjqac

[@YAHSHUA2285]

Good looking out Dr.Prasad Really good info thank God and my self I haven't got none of this Treatments done so I se it's always better to start from the inside out using fillers your Explanation makes alot of Cents thanks for your time Dr.Prasad

[@AmiyaPrasadMD]

You' re welcome, Roberto Fernandez! I'm happy you are watching the video closely, and it's helping you!

[@cretan982]

Great video. Was about to get a popular RF device off Amazon and glad I saw this first.

[@AmiyaPrasadMD]

Thanks, w rsg23! Glad the video helped you!

[@angelafoley446]

Me too 👍

[@arcims_razor9057]

FaceTite was marketed to me by my doctor vs a lower face lift. Big mistake. I will never get a radio frequency procedure again. I now have to get a neck lift to fix the laxity the RF procedure caused.

[@AmiyaPrasadMD]

Sorry to hear that, Rebekah Dunbar. You can refer to this more recent video about how skin can be rehabilitated after previous damage from thermal treatments - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@MR-fn7rw]

Pretty sure facetite isn’t an RF device, but a infrared light device

[@simonac688.]

Very informative and professional approach...thanks Doc

[@AmiyaPrasadMD]

Thanks beez.! Glad you found the video helpful

[@rosemarykennedy5430]

That was helpful . Thanks ❤

[@AmiyaPrasadMD]

You're welcome, @rosemarykennedy5430. I'm glad you found the video helpful.

[@BrandonEverett]

I love how I’m watching this as I’m healing from my first RF and Ultherapy session 😧😧😧

[@AmiyaPrasadMD]

Hi Brandon Everett, Facial volume loss is not caused by the devices by themselves, but by overheating or overexposure in the hands of the practitioner, and often on the insistence of the patient for more aggressive treatment for a lifting effect to avoid surgery. As long as you have an experienced and judicious practitioner, facial volume loss can be avoided with thermal treatments. I hope this clarifies things for you.

[@JMyungKun]

Does VBeam treatment used to remove facial broken capillaries cause facial volume loss as well?

[@AmiyaPrasadMD]

Hi Nicholas Lim, It’s important to remember that the particular device does not determine results, or causes complications, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@beautifulfacesskincare]

Thank you, this was excellent!

[@AmiyaPrasadMD]

Thank you, Beautiful Faces Skincare! Glad you found the video helpful!

[@violeticious9197]

Hello! Thank you for explaining all this. It’s great that there are doctors like you. I always like to do my research. Is there any natural way to help restore lost fat from radio frequency facial? Maybe with diet or massage or with hyaluron face serums? A year ago I went to a dermatology clinic and got 8 procedures. The lady dermatologist who had just got out of med school took this procedures as a joke and overcooked my forehead. After several procedures there was great effect and I wanted to get a treatment every 10 to 14 days, because that is what the internet said is best to wait, but the lady assured me it’s ok to get them each week and even with less than 5 days rest between procedures to match HER schedule. I trusted her because she is a doctor and said I was hypochondriac whenever I asked her a question. That was a red flag, but I stayed anyway because then I didn’t know better. She also didn’t do my eyebrows because the appliance was too big for that area and used it a lot on my cheeks near my nose and on forehead between the eyebrows . After one particular procedure I noticed my angry wrinkle became almost invisible, however my forehead was super flat between my eyebrows. The skin itself looked great and my cheekbones and jawline were visibly improved like contoured, however my forehead and the cheeks next to my nose were flatter. The center of my face looks flatter till this day and gives me a stupid expression. Nobody else could notice it, but I definitely do see it and it makes me wanna cry. I got a mini rf appliance to use at home and it is small and can be used on my eyebrows. Maybe my face will not look that flat between the eyebrows when the eyebrows themselves get the treatment. I also intend to not concentrate on fatty parts and not overcook my face because I feel like that is what that lady did. I feel like this would not have happened if the lady was more careful to not overcook the fatty parts of my face. She used way too much heat and the procedures were way too often and I feel like she made mistakes with my treatment because she was careless and arrogant. The clinic itself has good reputation and the young lady doesn’t work there anymore. Do you have any advice? I really really hate needles, though, I faint when I get a shot. Thank you for taking the time to read that long comment! 💕💕💕

[@AmiyaPrasadMD]

Hi Violeticious, Sorry to hear about your problem. I suggest you don't use an RF device at home as without the proper training, you can cause more damage. Platelet-rich plasma, or PRP as described in the video, is a natural treatment that can improve the health of the fat layer underneath the skin. It's natural because it comes from your own blood, but you do need an experienced doctor to prepare it, and inject it in the right areas for what I call tissue rehabilitation. I understand you don't like needles, but it can be done with topical anesthetic so you don't feel much, if anything at all. I hope this clarifies things for you.

[@monikamiliczka6104]

Thanks! RF it’s only bad If you over used it! In good hands it’s beneficial! I’d like to know the disadvantages of those fillers.

[@AmiyaPrasadMD]

Hi Monika Miliczka, You are absolutely right as the results of thermal treatments like radiofrequency and lasers are dependent on the doctor's skill, and the device is just their tool. The same principle applies to cosmetic fillers, as filler is just the material, and results are determined by the artist who is the doctor. The main disadvantage of hyaluronic acid fillers is they do need periodic maintenance. However, this disadvantage is also an advantage since hyaluronic acid fillers are safely metabolized by the body since hyaluronic acid is naturally produced by the body. Semi-permanent and permanent fillers usually result in severe complications from staying in the body too long, causing infection, migration, and foreign body reactions. I hope this clarifies things for you.

[@Phoenixtwinflame363]

I had Ultheraoy done 3 times on my neck and once on my face and under eyes to "tighten" the skin, spending thousands each time and enduring a LOT of pain in the process. What did I end up with? Severe crepey neck skin and atrophy of fat under my eyes!! Its taken years to finally discover that these frequency devices that supposedly are supposed to tighten actually do the complete opposite!! I've looked 10-15 yrs younger my entire life, to the point where I still got carded well into my 50's. However, I could not understand why it was that my neck, in the middle, looks so saggy, crepey, older looking than my 75 told mother at times. I now need a neck lift and surgeons have warned me it may not last more than a couple yrs due to the unusually thin, poor quality due to loss of fat, elastin, I have to my neck. When I told them I've done Ultherapy 3 times to my neck they stated that's the problem...fat depleted due to this device!! And, I never had a loss of fat under my eyes until doing Ultherapy in that area. I'm now also wondering if the clear & brilliant & fraxil laser treatments I've done were also depleting my fat as well?! Anything that heats the under dermis of skin depletes fat! I'm so angry that I put my trust in these doctors and all that $$$ to look worse and be so ashamed and uncomfortable to show my neck!!

[@AmiyaPrasadMD]

Hi Heidi D'Angelo, Sorry to hear about what happened to you. I actually don't use high frequency ultrasound devices in my practice as they heat to suddenly, I prefer devices with greater temperature control to avoid complications. While you did indicate this in your comments, it's important to note that results, or complications are determined by the judgment, experience, and skill of the doctor or practitioner using the device, not the device itself. You can refer to this more recent video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@Ye80s]

Then how to restore. You should have told us earlier.

[@AmiyaPrasadMD]

Hi Ye80s, You can refer to my older videos about restoring the fat layer affected by overuse of heat treatments: kzbin.info/www/bejne/aYHOfHR3qt-abs0 kzbin.info/www/bejne/b4mzpKN7Z8-UgtU

[@anjalidarade5405]

Pl let me know glad to meet you

[@AmiyaPrasadMD]

Hi Anjali Darade, Sorry, although I'm of Indian descent, I only practice medicine in the US.

[@larayne]

Really great explanations, thank you. How do you feel about sculptra vs HA for re-volumization of the face?

[@AmiyaPrasadMD]

Hi La Rayne, I prefer hyaluronic acid fillers for facial volume because they are more predictable, and volume is created by the filler material itself. Sculptra that uses poly-L-lactic acid relies on a metabolic reaction to create volume, so the shape, and results are not as predictable. I hope this clarifies things for you.

[@larayne]

Amiya Prasad, M.D. , thanks, yes, this makes sense. I‘ve tried both and the volume gain is somewhat unpredictable with Sculptra, but personally, I found that sculptra looks more natural than an HA correction (depending on the viscosity of the product and placement, HA can look more like an implant rather than natural facial fat, esp. when moving the face - but it‘s definitely more predictable - as I get older, I don‘t respond quite so well to sculptra. ) Maybe I‘ll try fat transfer once I reach 50. 🤔 Thanks for all your useful clips!

[@malis1473]

Why do we see celebrities with bad looking faces due to fillers? Is that because the skin stretches every time and you need a bigger filler that in the long term will end up in sagging even harder ??how many years you can use a filler before it looses its effectiveness?5 years? And also what do you think of mini injectables such as Profhilo???

[@AmiyaPrasadMD]

Hi newlife s, The most likely reason why you see celebrities looking puffy and doughy is that the filler placed in a superficial level of the face migrates. Filler can be placed at the bone level, and in between the muscle to completely avoid this look. Fillers also do not stretch the skin. You can refer to these videos about these exact issues you are asking about: kzbin.info/www/bejne/eKPFZaiKr996bpo kzbin.info/www/bejne/nqmYZWOneauVqNU Also, Profhilo is a hyaluronic acid filler that's still not in use in the US, but it appears to be comparable to others on the market. Results aren't determined by the filler material, but by the skill and experience of the doctor using them. I hope this clarifies things for you.

[@malis1473]

But these celebrities go to renown clinics and doctors , what I want to say is , hard to believe it’s not because of face dropping , gravity necessity to now fill even a more hollow area

[@AmiyaPrasadMD]

Hi newlife s, I hope you saw the videos about placing filler at the bone level, which completely avoids the bloated facial look, and looks more defined and angular. Not many doctors perform this technique of filler placement, even the ones you consider renowned. I hope this clarifies things further for you.

[@havad3938]

You're an angel- being so responsive, as a busy surgeon...Are there any home devices safe (to not losing fat)? I read RF (or high frequency?) was ok below 41 C... I'm looking into sonic devices, micro current, and Dr. pen. Thank you

[@AmiyaPrasadMD]

Hi Havad, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. At home devices are used by people without proper training with the device, and instructions are not comprehensive enough to adjust for treatment of different skin issues, or different skin types. Also, people without training tend to use the device too frequently, and without enough healing time between sessions for collagen induction. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@BostonPower]

DOCTOR, HOW OFTEN CAN I SAFELY DO A CARBON PEEL? I AM 50 WITH NO SAGGING OR FAT LOSS. THANK YOU! IT'S NICE TO GET AN UNBIASED VIEW ON LASERS.

[@AmiyaPrasadMD]

Hi flexiblematthew, I would have to examine what you are looking to treat, as well as the condition of your skin before recommending how many sessions you would need. It is important to allow for healing, and for collagen generation between sessions, which are usually 4-6 weeks apart. How many treatments you would need can be determined by how you respond to the initial sessions. I hope this helps you.

[@BostonPower]

@@AmiyaPrasadMD THANK YOU KINDLY. I FORGOT TO ASK YOU IF THERE'S A RISK OF FAT LOSS WITH REPEATED SESSIONS?

[@AmiyaPrasadMD]

Hi@@BostonPower, Fat loss is most often to overheating or overexposure, so this risk is reduced by the experience of the doctor performing it. I avoid overexposure by alternating laser treatments with PRP injections, which still stimulate collagen, but without heat. I hope this clarifies things for you.

[@BostonPower]

@@AmiyaPrasadMD THANK YOU KINDLY!

[@AmiyaPrasadMD]

You're welcome, @@BostonPower!

[@btctothemoon7504]

liked, subscribed, n saved the video. so informative, thank u

[@AmiyaPrasadMD]

Thank you for watching and subscribing, Anney RN! I'm glad you found the video helpful! I do have a more recent video about this topic, for your reference - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@truth-alwayswins]

Beautiful work💙

[@AmiyaPrasadMD]

Thank you for the compliment, Truth!

[@lynnkristy1]

Thank you for this information.

[@AmiyaPrasadMD]

You're welcome, Lynn Kristy! Glad you found the video informative.

[@valvalp888]

Thank you Dr. Prasad! In addition to the solutions you offer in this video do you ever repose the lost fat with facial fat transfers? or is that something you do not do? Thank you! all the best to you!

[@AmiyaPrasadMD]

Hi ValVal P, Yes, facial fat transfers are treatments I do perform, and is safer for the cheeks and around the mouth as the skin here is thicker than the lower eyelids, but it should be noted that 30-70% of transferred fat is quickly absorbed by the body, so at least 2 sessions are usually needed. If you want to restore facial volume more predictably, and more conveniently, I would perform injectable filler treatment. I hope this clarifies things for you.

[@valvalp888]

@@AmiyaPrasadMD Yes, it does! Thank you so much for your response! I really appreciate it!!

[@AmiyaPrasadMD]

You're welcome, ValVal P!

[@biazac]

Very good explanation Dr. What do you think about Fotona? People say it doesn't lose facial fat, I would like to know your opinion about Fotona.

[@AmiyaPrasadMD]

Hi @biazac, While I do feature Fotona in my videos as I use their lasers in my offices, it’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@carlogiordano4793]

Hi Doc! You seem to be both knowlwdgeable and honest! I'd love to know what you think about led light therapy. Thank you very much in advance for your response :-)

[@AmiyaPrasadMD]

Hi carlo giordano, While red light therapy has been around for some time, especially for laser caps that I don't find effective for hair loss, the devices for the skin are fairly new. I think that stimulation of collagen production is more proven and effective with various more intense laser treatments, PRP, microneedling, and skin boosting. I hope this clarifies things for you.

[@pamkakes]

Is it safe to do micro needling after a laser treatment? How long would you suggest to wait after laser to do microneedling? What frequency is safe and what depth of needle is safe and still effective? Thank you.

[@AmiyaPrasadMD]

Hi Raw vegan Pam, Your skin needs to heal after laser or microneedling treatment, so they're not safe to do together. Consult your doctor about what works best for your skin, but it's usually 4-8 weeks spaced apart. Depth is also determined by thickness of your skin and problem you are looking to treat. I hope this clarifies things for you.

[@lorestrahan2207]

What is the best way of removing fine lines under the eyes? I have fine lines under my eyes only when I smile.

[@AmiyaPrasadMD]

Hi Lore Strahan, You can refer to this video about the different treatments for lines and wrinkles in the eye area - kzbin.info/www/bejne/homwmYxvZbmFm68

[@franny5047]

Can you please make a video on non-surgical options for people with autoimmune issues like rheumatoid arthritis? I think our options are so limited. It's disheartening.

[@AmiyaPrasadMD]

Hi Frances, There is a wide spectrum on the severity of rheumatoid arthritis, so it's too broad a topic to really cover for all possible treatments. Generally, we assess a patient's severity of rheumatoid arthritis, immunosuppressive drugs they are taking, and their medical records before deciding on treatment. I do often treat patients with rheumatoid arthritis with various procedures, but this is on a case-by-case basis. I hope this clarifies things for you.

[@franny5047]

@@AmiyaPrasadMD Thank you so much for the quick response. It totally makes sense that procedures vary on a case by case basis. I just wanted to hear that there was hope for RA patients to undergo rejuvenating cosmetic procedures :)

[@AmiyaPrasadMD]

You're welcome,@@franny5047 ! There is definitely hope as I do treat patients with rheumatoid arthritis regularly.

[@OE2023]

Hi doctor, love your work 🙏🏾 wish more of this information was shown for people buying home devices. I hope you don't mind me asking I bought a device from amazon it hardly heats at all (RF) but the microcurrent is strong I've used it a lot of times because of the instructions but now I'm thinking what if I've caused fat loss. If the device doesn't get hot should I be okay? (I'm 26) many thanks Emma

[@AmiyaPrasadMD]

Hi She's Circa, I generally don't recommend use of home heating devices because a general set of instructions for use can't apply to every skin type and condition, and people using these devices have little to no training in using them. Keep in mind that collagen is stimulated by these devices on a controlled injury model, so without proper training, you are literally hurting your skin. I hope this clarifies things for you.

[@OE2023]

@@AmiyaPrasadMD Thank you it does ❤️

[@AmiyaPrasadMD]

You're welcome, @@OE2023!

[@missyheev508]

What about micro current? Will there be harsh consequences after stop continuous using?

[@AmiyaPrasadMD]

Hi Missy Heev, Micro current is not a heat treatment, so it doesn't have the same possible effects on facial volume loss. However, I don't think micro current treatments are effective, so I don't use them in my practice. I hope this clarifies things for you.

[@missyheev508]

@@AmiyaPrasadMD Thank you so much for answering! As always not many response their viewers I just had to post the question since I been using micro current device for 4 months and was concern after seeing your video. Really appreciate and am relieved.

[@AmiyaPrasadMD]

You're welcome, @@missyheev508!

[@chypiuusa]

thank you for the fantastic video ! what is the device you use to deliver PRP and HA and would it cause any bleeding/bruising?

[@AmiyaPrasadMD]

Hi tramchip, Avoiding excessive bruising and bleeding depends on the area of the face, but generally it's about avoiding vessels, and in some areas of thicker tissue using blunt cannulas instead of needles. I hope this clarifies things for you.

[@yazidtouahria9810]

Hello doctor, what do you think of fat graft after a facial fat loss caused by radiofrequency session ? Thank you doctor

[@AmiyaPrasadMD]

Hi Travel Mark, I wouldn't advise a facial fat graft to treat volume loss due to overheating. Fat grafting is not predictable because 30-70% of grafted fat is absorbed by the body quickly after the procedure, so volume will likely look uneven and asymmetric. I hope this clarifies things for you.

[@yazidtouahria9810]

Amiya Prasad, M.D. to conclude in the case of a skin rehabilitation caused by overheating, we can not regain 100% of the volume lost? whether it be with prp, fat injection or whatever?

[@AmiyaPrasadMD]

Hi@@yazidtouahria9810, It does depend on the extent of damage, and how you respond to treatment. Without a physical examination, and actually attempting treatment, I can't say for sure. However, when fat cells are lost, they are lost permanently, but remaining fat can be made healthier for the appearance of youthful volume. I hope this helps you.

[@yazidtouahria9810]

Amiya Prasad, M.D. Thank you doctor, youre the best

[@AmiyaPrasadMD]

You're welcome,@@yazidtouahria9810! And thank you for the kind words!

[@Ramadan393]

What treatments do you recommend for malar festoons? I’m in my early 20s. Also can’t visit you I’m in a different country but your truly amazing and extremely informative!

[@AmiyaPrasadMD]

Hi Qadira Qudratullo, Thank you for your kind words, and for watching! Malar festoons are challenging to treat, especially when they are caused by fluid trapped in many small chambers. An examination is needed to determine what is the best treatment for you, but I do have some older videos featuring different options for treating them: kzbin.info/www/bejne/l5CXhaGOlKZjgKM kzbin.info/www/bejne/bny0XnWgbb10jZY

[@GiveHimGlory89]

What is more effective for acne scars, microneedling rf or microneedling with prp in your experience? ( I subscribed and liked your videos btw doc).

[@AmiyaPrasadMD]

Hi Brandon Prazak, Thank you for watching, liking, and subscribing! While I don't use RF microneedling in my practice, and use microneedling less often as there are other collagen induction therapies available, there is no single best treatment for acne scars that applies to every case, and every skin type. You can refer to these videos about it: kzbin.info/www/bejne/Z3Ksg4SYftqDqK8 kzbin.info/www/bejne/g6fXdax5jrqahZY

[@priscillapilates640]

@@AmiyaPrasadMD Hi Dr, Which other collagen induction therapies do you recommend against Microneedling? I have just had my second microneedling procedure and loved the results.

[@4AMPizza]

Doctor, is there a lower risk of facial fat loss with non-ablative lasers? Neo-elite Aerolase, for instance?

[@AmiyaPrasadMD]

Hi @4AMPizza, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The laser is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this more recent video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@jennyquezada9644]

Is okay to get laser genesis every other month?

[@AmiyaPrasadMD]

Hi Jenny Quezada, It depends on the area being treated, and the intensity and duration of each treatment session. I hope this clarifies things for you.

[@saracorsi6499]

Very interesting, thank you for your work. Unfortunately, i live in Australia, so really can’t book a consultation. We lack of good professionals here, after months researching i still don’t who to turn to for skin resurfacing. Come and visit us! :)

[@AmiyaPrasadMD]

Hi sara corsi, My understanding is that dermatologic services such as acne treatment, and acne scar treatment are covered by your public health services. Not sure if skin tightening is covered as well, but you do have many dermatologists available to you in Australia.

[@saracorsi6499]

@@AmiyaPrasadMD skin tightening is not covered unfortunately. It’s understandable though. Yes, we have dermatologists and plastic surgeons. If you had any to recommend, that would be great. I used to follow your videos at the beginning of my thyroid eyes disease. The skin laxity of my upper eyelids is something i’d like to correct, it’s a constant sad reminder of the disease which is now under control. I think it has had also a (negative) impact on my face overall. Thanks :)

[@esmidt529]

Hello Dr. Prasad, Thank you very much for this educational video. I have a question. I have lost weight when I stopped using the birth control pil. Fat has also disappeared in my face, that has changed my appearience and I am very sad about that. Can I use an Ultrasonic Rechargeable Face Skin Scrubber Facial Cleaning Blackhead Removal Cleaner without risk of losing more fat in my face? Specs of this device: Facial skin ultrasonic scrubber works for gently peel horniness and skin rejuvenation. It removes and eliminates dead cell effectively to avoid the cuticle stacking. When using for several days, this ultrasonic facial cleaner can relieve melanin and dirt, firm wrinkles and whiten skin, help restore the elasticity of skin and make your skin firm, smooth and delicate. Ultrasonic vibration 28000Hz per second. Thank you in advance for your reply. Esther - The Netherlands

[@AmiyaPrasadMD]

Hi Esther, Home devices are usually not hot enough to cause fat loss, but since they are used with medical no training, there is a potential for misuse or overuse. I'm not familiar with that particular device, but generally they claim benefits that they will likely not live up to. I can't give a certain yes or no answer, but I can advise you to be careful with any home based device, and be wary of their claims. I hope this helps you.

[@esmidt529]

@@AmiyaPrasadMD Thank you so much for your reply.

[@AmiyaPrasadMD]

You're welcome,@@esmidt529!

[@reneesam6963]

Thank you dr. Amiya Prasad , my question what your secret to keep your face the same for many years since first show , your never again , I like your show

[@AmiyaPrasadMD]

Thanks for watching all this time, renee sam! You can come visit us to learn about what treatments will work best for you!

[@reneesam6963]

Amiya Prasad, M.D. Thank you so much dr. I wish if I can visit , but I live in different country

[@michaelr5100]

Dr. Prasad, would you recommend RF as maintenance for someone in their 30s with only slight laxity/sagging?

[@AmiyaPrasadMD]

Hi Michael R, I would have to examine your skin, as well as loss of facial volume before making specific recommendations. I did make a video about treating the first signs of facial aging, for your reference - kzbin.info/www/bejne/j3Tal2iabt5kjpI

[@leidypedraza8684]

Hi Dr. thanks for such a information. Please let me know if Q-switch laser is safe. I am using it for skin texture repair, after acne. I got scheduled with 12 treatments every two weeks taking one. I already had 8. Please let me know if is safe or if u recommend me a better option. Thank you.

[@AmiyaPrasadMD]

Hi Luna Vida, Q switch laser is relatively safe, as safety of any device is determined by the practitioner using it. As your doctor has examined your skin and I have not, it's not my place to recommend another option, so I would defer to your doctor's treatment plan. I hope this clarifies things foryou.

[@bojanadjordjevic7063]

Hi, can Fractora in some way replace fract. CO2 when it comes to results for reducing acne scars? Thanks!

[@AmiyaPrasadMD]

Hi Bojana Lazarevic, Although I don't use Fractora in my practice, I do use another radiofrequency device called Pelleve. A physical exam is needed to determine the best treatments for acne scars, as there is no single best treatment like fractional CO2 laser that applies to everyone, and every skin type. You can refer to this video for more details - kzbin.info/www/bejne/Z3Ksg4SYftqDqK8

[@Jade-sm3pk]

Can gaining wight help the Neck if one is thinner ? Or once the fat volume is gone from the neck it’s gone?? Thank you for video and info:)

[@AmiyaPrasadMD]

Hi Jade Strutinski, Gaining weight may make your other areas of your body disproportionate, so it may not be the best approach in improving appearance. It's unclear if you lost neck volume from a previous treatment, or if it's just naturally thin. There are healthy and proportionate ways to gain weight with diet and exercise if one is naturally thin. I hope this helps you.

[@Jade-sm3pk]

Thank you for your reply :)

[@Jade-sm3pk]

@@AmiyaPrasadMD Thanks for your reply:)

[@AmiyaPrasadMD]

You're welcome, @@Jade-sm3pk

[@lyndabaker4212]

What would you recommend for medium dark Mexican skin that hyperpigmentation easily ? I was recommended profound or picosure. What do you think about the PRP and hyloronic acid?

[@AmiyaPrasadMD]

Hi Lynda Baker, It's not clear what issue you are trying to treat, but it is crucial that examine the problem you want treated, and your skin type before I make specific treatment recommendations. I hope this helps you.

[@Rose82155]

Thank you for the video. May I ask, Can you get fat loss from getting Fraxel laser treatment? Or is it typically just RF?

[@AmiyaPrasadMD]

Hi Angela Murphy, It’s important to remember that the particular device does not determine results, or causes complications, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@BrightWinter23]

Hello! Do you recommend fibroblast for the eye area? I have thin skin under eyes. What is your opinion on the treatment??

[@AmiyaPrasadMD]

Hi BrightWinter23, Fibroblasts are recruited with PRP treatment, and PRP injections are what I normally recommend and administer to thicken thin lower eyelid skin. You can refer to these more recent videos about it: kzbin.info/www/bejne/i4KQZ51_m8ZmsLM kzbin.info/www/bejne/b56alH6If5udb5o

[@JohnSmith-sj2dk]

Hi Dr Prasad, I am considering PSR (Plasma Skin Resurfacing), do you think this technology is less likely to cause volume loss?

[@AmiyaPrasadMD]

Hi Glenn Williams, While I don't use that particular technology, it’s important to remember that the particular device does not determine results, or causes complications, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications.

[@alanbritofinito2940]

I am 50 and they are offering me an RF treatment called morpheus8, will it be convenient?

[@AmiyaPrasadMD]

Hi Alan Britofinito, It’s important to remember that the particular device does not determine results, or causes complications, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@micdeleon]

...can the at home rf devices cause volume loss? I believe the one I have is 5 watts.

[@AmiyaPrasadMD]

Hi micdeleon, It is possible depending on the amount of exposure. The problems with home skin heating or microneedling devices are unknowingly using them too often, too aggressively, overexposure, or not giving the skin a chance to recover between sessions. I hope this clarifies things for you.

[@karoliina7957]

Thank you for the video! Is fractional RF the same as ”normal” RF or are they different? Also, what kind of treatment would you recommend for a ”bottom heavy” face? My face is not exactly chubby but I’ve always had prominent / heavy lower cheeks, like a chipmunk or a bulldog, and I feel like as I age my midface loses fullness but the fat in lower cheeks and jawline remains. I’m 27 soon and would like to prevent jowls and tighten and slim the cheek and jawline area - could RF be an option?

[@AmiyaPrasadMD]

Hi Karoliina, Regular and fractional radiofrequency devices have similar effects, but if you have lighter skin not prone to hyperpigmentation, laser treatment is generally more effective and predictable. Results or complications of laser treatments are determined by the experience and judgment of the doctor performing the treatment, not the device itself. An evaluation is needed to determine what could best helps you, especially since you are still very young. You can refer to this video about the right age for laser treatment - kzbin.info/www/bejne/oHiZdoltmbaYmJo

[@sabaiftikhar9040]

Hi Dr Prasad, are you planning to open a clinic in uk? I would love you be your client but you are soooo far away for me.

[@AmiyaPrasadMD]

Hi saba Iftikhar, Sorry, not planning a UK clinic at this time as travel does take a lot of time from my current patients. We do have many international patients coming every day, so come visit us if you can!

[@sabaiftikhar9040]

That is my future plan. Thank you for your prompt reply xx

[@AmiyaPrasadMD]

You're welcome, Saba!

[@anaduca4461]

dear Dr. kindly advise a.what method is more efficient to do vampire prp? Inhectablr or dermapen? it's not on the video's subject but appreciate your reply b. with what method could I improve my skin tonus more with colagen to have a more healthy face look. thanks in advance!!!!

[@AmiyaPrasadMD]

Hi Ana Duca, The Vampire Facelift is a specific treatment of PRP with a single syringe of hyaluronic acid filler that has to be injected. The Vampire Facial is done with microneedling. I do apply PRP with microneedling as well. The best treatment for you would have to be determined with a physical exam first, then we can discuss the many options to induce collagen. It's important to keep in mind that there is a limit to collagen stimulation, and your body can't produce more collagen if you do more aggressive treatments. I hope this clarifies things for you.

[@siyachari9107]

what's about LED light for fighting acne bacteria, does it safe for hyper pigmentation or heat side effects? thanks in advance

[@AmiyaPrasadMD]

Hi siyapar chari, LED does not generate heat to cause hyperpigmentation, and is a shorter wavelength so it doesn't penetrate very deeply. I would have to examine your skin and your issues to determine a more effective treatment for you, that also avoids complications like hyperpigmentation. It's important to keep in mind that it's not the device that causes hyperpigmentation and complications, but the skill of the practitioner using and selecting the device that causes these issues, and also determines results. I hope this helps you.

[@jimboland1730]

Very informative video.

[@AmiyaPrasadMD]

Thanks Jim Boland! Glad you found it informative.

[@olgacherry-ix3km]

Thank you so much for the video -while it was informative, it still left me confused. I was recommended ultherapy in order to lift my face a little bit in order to reduce nasolabial folds. I am in my late 30s I only have insignificant gravitation of the face downwards, however, it is making those laugh lines more prominent. but after this video, I am not sure will the ultherapy give me any significant results or that it would be worth the high price of the procedure. 😢

[@AmiyaPrasadMD]

Hi Olga cherry, Complications from thermal devices most often happen when a device meant for skin tightening is used excessively, or more intensely to get a non-surgical lift. We do treat nasolabial folds non-surgically by addressing the facial volume loss that causes them. You can refer to these videos about it: kzbin.info/www/bejne/qHTNpoh3pMt4fLc kzbin.info/www/bejne/eGKsc5WHfZh7d7M

[@OliveB69]

Can the Cool Peel CO2 laser cause facial fat loss? I was going to have it done for the acne scars on my cheeks.

[@AmiyaPrasadMD]

Hi Olivia Reinhardt, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@dandelions2414]

I wish I saw this before my facial fat was all melted from laser!

[@AmiyaPrasadMD]

Sorry to hear that, Dandelion S. Lasers can be useful when in the proper hands, but complications arise in cases of overheating or overexposure. It's important to find a doctor who uses thermal treatments conservatively to avoid complications. I do have a more recent video about treating volume loss after laser treatment that may help you - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@Dandelion_flight]

Dr Prasad, do you make any videos on acid peels? Thank you.

[@AmiyaPrasadMD]

Sorry, I don't. Acid peels are the gold standard for skin resurfacing, but lasers have largely replaced them as they are more precise and customizable. I hope this clarifies things for you.

[@flowerbackdrops9383]

I love you videos. Does laser hair rein the face damage the face . I’ve done laser hair removal on my face and since then I noticed the hair on my face getting thicker and my face get really dry since and pores open. Ever since then I don’t have that smoothe dewy face anymore. Also can you tell me which is better -microneedling or twinlight fractional rejuvenation ( fatona micro laser peel)

[@AmiyaPrasadMD]

Hi Flower Backdrops, It’s important to remember that the particular device does not determine results, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. The problem with home-based devices is that the person operating them is not properly trained to use them, and instructions that come with them are not detailed enough, and people using them don't know how to adjust them for different conditions and skin types. I hope this clarifies things for you.

[@user-ht1ft3dy3s]

I'm treating some veins under my eyes with Nd: YAG laser 1064 nm. Can this laser at this frequency cause fat loss?

[@AmiyaPrasadMD]

Hi C, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@tlapo9671]

Dr Prasad- if a poorly trained person performed a DOT laser aggressively on a patients face, could it cause fat to displace onto the neck/ collarbone area?

[@AmiyaPrasadMD]

Hi T LaPo, Overly aggressive laser treatments don't cause fat to be moved somewhere else, but rather shrunk, then literally cooked under high temperature exposure for too long. Fat requires a blood supply to remain in a given location, so it is more likely that the fat in the collarbone and neck are native to those areas, and the fat cells in those areas may have gotten bigger with weight gain. I hope this clarifies things for you.

[@KyleTO7]

If RF devices cause fat loss then wouldn't that be a perfect device to use for under the eyes if it's all subcutaneous fat pads causing the puffiness?

[@AmiyaPrasadMD]

Hi Kyle 0, That's not the way it works as lower eyelid skin is very delicate since it's the thinnest skin in the body at only 0.5mm thick, and the lower eyelids do not have the essential fat layer that is affected by overheating or overexposure to thermal treatments. I hope this clarifies things for you.

[@chowaakter3947]

Sir Thnq Um From Bangladesh .I just wanna know That Is It Really Worked (RF) To our Belly Fat back side Fat Melting um so Confused that It is Worked & also it's Not Risky to our Health or Our Tissues? Plzz give me Suggestions 🙂

[@AmiyaPrasadMD]

Hi Chowa Akter, I usually encourage my patients to reduce weight and fat volume with diet and exercise first. I then treat these patients with thermal devices for fat loss when they are already within 10 pounds of their target body weight, and use a thermal treatment for the stubborn problem areas. I don't recommend fat reduction using a thermal device alone. I hope this clarifies things for you.

[@karinatulla9488]

Hi Doctor. I have a question, what kind of laser do you recommend for acne and dull skin? I have problem with Acne scar and my face skin color is dull. So yesterday, I went to one of the famous clinic in Germany. I was gonna choose Laser CO2 but then the doctor told me, Laser CO2 isn't good for my skin, because it will turn my skin tone darker. And He recommended me to get laser Radio-frequency needling for 2-3 treatments. Do you think should i get it? Or maybe if you have an advice about what is the best treatment lf acne scar. Thanks.

[@AmiyaPrasadMD]

Hi KARINA AMELIA, I hope you understand that I can't recommend specific laser treatment for you without examining your issue, and your skin type first. While I don't perform RF microneedling, I do perform RF treatments for people with darker skin types that may have issues with hyperpigmentation from CO2 laser. As your doctor has examined your skin, and I have not, I would defer to their judgment. You can refer to this video about why there is no single best treatment for acne scars that applies to everyone - kzbin.info/www/bejne/Z3Ksg4SYftqDqK8

[@TubeYoYOYO]

Is Venus Freeze a better alternative to avoid volume loss? It works on magnetized pulses and Radio Frequency.

[@AmiyaPrasadMD]

Hi Dreamy, It’s important to remember that the particular device does not determine results, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. I hope this clarifies things for you.

[@makeupbykulz8603]

Hi there , I’m planning on having Harmony XL pro ipixel and clear lift treatment done , would these devises come under thermal heating ? The ipixel I believe only work on the top layer of the skin and scabs .. clear lift is deeper , please do advice us abd thank you ❤

[@AmiyaPrasadMD]

Hi Makeupbykulz, While I don't use these devices in my practice, they are indeed lasers which fall under thermal/ heating devices. It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@petyaarmyanova793]

If fat loss has occurred, do these fats reappear naturally or is it permanent? Thank you in advance!

[@AmiyaPrasadMD]

Hi petya Armyanova, Damaged or removed fat cells are permanently gone. Remaining fat cells can fluctuate in volume, which is why volume can still be visible if fat cells are removed. The essential fat layer can still be improved after complications of aggressive laser treatments with skin rehabilitation treatments like PRP, which can be confirmed in a physical exam. I hope this clarifies things for you.

[@skinsciencebymira]

What about Ultherapy aka ultrasound? Doesn’t that work in the SMAS?

[@AmiyaPrasadMD]

Hi Mira Parker, Ultherapy can heat the SMAS, but it's not going to tighten it like a proper surgical facelift. Ultherapy can also cause fat loss, especially since it heats quickly, and not gradually like laser and radiofrequency devices. I hope this clarifies things for you.

[@ZaraQadir97]

I wish I would have seen it earlier. I lost facial volume from Duvet and RF treatment. The complexion has become darkened and I lost the natural glow on my face. What should I do to improve my complexion and to restore some volume. I'm so stressed and I cant visit US. Thanks doc.

[@AmiyaPrasadMD]

Hi Humera Aslam, Sorry to hear about your problem. You can look for a local doctor in your area who performs PRP injections to help improve the fat layer under the skin, as well as improve skin thickness and quality. You may need several treatment sessions for best results. I hope this clarifies things for you.

[@eve7096]

Dr. Prasad what could I use for TCA peel burn/damage to skin? I'm really unhappy about the issue please help!

[@AmiyaPrasadMD]

Hi Eve, PRP can help with damaged skin, but I would need to examine your skin and the extent of damage to make specific recommendations for you. I hope this helps you.

[@arymhansie]

Dr Prasad, what do you recommend for melasma??

[@AmiyaPrasadMD]

Hi arym hansie, Melasma is usually treated by a laser, which is detailed in this video kzbin.info/www/bejne/hWXPqZ-PlJ6Uoa8

[@lauragwillim1055]

Great video! Thank you❤️

[@AmiyaPrasadMD]

Thank you for being a loyal viewer, Laura! Glad you found the video helpful!

[@lauragwillim1055]

Amiya Prasad, M.D. I may have to find a way to come see you! I like your comprehensive approach to skin rejuvenation and anti-aging. I’m in a small town in Georgia with 3 plastic surgeons and 3 medical estheticians. I’ve been to all 3 medical estheticians for various treatments, but never evaluated by the plastic surgeons. The MDs mostly do surgery but it’s all over the place. None are facial /maxillary specialists. New York is just a plane ride away!

[@AmiyaPrasadMD]

Come see us anytime, Laura! We do have patients coming in from around the country and around the world every day. You can also spend some time in New York which doesn't run out of things to do :)

[@jonilapointe6494]

HI Dr. Prasad, I have had a co2 treatment which has been referred to as Dot. Immediately I had malasma occur, which I never had before. I received a cream that seemed to be effective to calm the malasma. Later I noticed that my skin didn't feel the same and I began to see what looked like breakouts. These breakouts were odd in that they appeared in a row of three. Looking much like a pimple, except (3). As time passed the pimple like lesion became a dark spot and then a pock mark scar. This keeps occuring on my face and I am ay a loss of what if anything I can do. My doctor has decided to ignore my situation which makes me skeptical. I have also noticed his nurse praticioner who did the procedure is no longer working there. Also, my esthetician of 7 years is also gone. Do you have any advice that you can pass along to me? I'm located in San Diego, California. I can provide pictures if you would like.

[@AmiyaPrasadMD]

Hi Joni LaPointe, Sorry to hear about your problem, but I would have to physically examine your skin for a proper second opinion before I can recommend a strategy for you. I hope you understand that making recommendations based on just your description alone, or even pictures that don't reveal details of your skin, and not performing the recommended procedure myself, has the potential to make things worse for you. I hope you understand.

[@visco876]

I have dark circles and dermatologist adviced 8 session of Venus freeze plus treatment ,Low energy RF and Magnetic pulses for Blood circulation and lymphatic drainage and 4 session of melanostop and nomelan peel Does that sounds ok ?

[@AmiyaPrasadMD]

Hi vishal sanghavi, I haven't examined your skin like your dermatologist has, so it's not my place to contradict their recommendations. You can refer to these videos about how I usually treat dark under eye circles for my patients: kzbin.info/www/bejne/h3PZm52srbWnaMk kzbin.info/www/bejne/oIK4k2lth9WUd68 kzbin.info/www/bejne/iWfCn4eIp5ann9E

[@zoedaflower9914]

Are black skin qualify for these kind of treatment? whats the pros and the cons on black skin?

[@AmiyaPrasadMD]

Hi zoe Daflower, Lasers need to be used very carefully, or not at all on dark skin types because of high likelihood of hyperpigmentation of hypopigmentation. There are lasers that are not as aggressive, or energy settings and/or exposure can be reduced. There are also alternative treatments like radiofrequency for darker skin. A physical exam can determine what treatment best suits your skin and your issue. I hope this clarifies things for you.

[@zoedaflower9914]

@@AmiyaPrasadMD thank you so much for this. what's the best fillers for black skin. and what the major side effect cause by fillers?. i want to get fillers in my nasal fold. but scared to because our skin are so easily damage.

[@AmiyaPrasadMD]

Hi @@zoedaflower9914, Hyaluronic acid fillers like those in the Restylane and Juvederm family are the safest to use, as long as they are applied by a doctor experienced in facial fillers, and applying them to patients with dark skin. You can watch this video for more information, and it does include a Latina lady with darker skin - kzbin.info/www/bejne/rZbCmJenhKetiqc

[@mariposa6157]

What is the solution for losing fat and volume after laser co2 on face ?

[@AmiyaPrasadMD]

Hi Mariposa, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@ainsleyspencer4555]

Dr happy 2020 hope all the well for you and your business what is your view on BTL exiles that uses RF and ultrasound for fat reduction and skin tightening

[@AmiyaPrasadMD]

Happy New Year, Ainsley Spencer! I don't use high frequency ultrasound devices in my practice because of sudden and high heat, but I do use various lasers as well as RF devices like Pelleve for skin toning and tightening that have more gradual heating. Fat reduction using thermal devices can be unpredictable, so I do prefer using liposculpture. I hope this clarifies things for you.

[@madeleinebugbee2986]

Can facial fat loss be easily avoided with Morpheus8 if set to only 1 or 2 mm?

[@AmiyaPrasadMD]

Hi Madeleine Bugbee, It’s important to remember that the particular device does not determine results, or causes complications, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. You can refer to this video about it - kzbin.info/www/bejne/oYvYq2aGpLmcZqs

[@vibha.anand3856]

Hi doc, is mini radiofrequency device safe to be used at home? My aim is to lose fat from lower face and skin tightening....mini rf device is available in 2 MHz, 3 mhz and 5 MHz online..,,. Which one should I choose? Please reply...

[@AmiyaPrasadMD]

Hi Aleesha Sayed, It’s important to remember that the particular device does not determine results, but rather the experience and judgment of the doctor using the device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. At home devices are used by people without proper training with the device, and instructions are not comprehensive enough to adjust for treatment of different skin issues, or different skin types. I hope this clarifies things for you.

[@anjalidarade5405]

Sir do you come to Mumbai

[@AmiyaPrasadMD]

Hi Anjali Darade, Sorry, although I'm of Indian descent, I only practice medicine in the US.

[@nz2737]

Is this specifically for lasers that target fat cells or all laser ? For example is this a risk of lasers like excel V that only target blood vessels ?

[@AmiyaPrasadMD]

Hi Nairuz Almaghrawi, It’s important to remember that the laser itself does not cause complications like facial volume loss, nor does it determine successful results, but rather the experience and judgment of the doctor using the laser or other device. The device is just a tool, and it’s the doctor’s judgment using the tool that separates great results from ineffectiveness, or potential complications. I hope this clarifies things for you.

[@stavroskolliniatis9352]

I'm 20 and this year I still had babyfat on my face. People always thought I was a teen. Unfortunately this year I had a Fraxel treatment with microneedking and I feel like that 1 fraxel treatment burned off my baby fat if that makes sense. It still dishesrtens me to this day and I feel disfigured. What can I do to help fix this damage?

[@stavroskolliniatis9352]

I feel like I've lost that baby face look and I hate it.

[@AmiyaPrasadMD]

Hi @stavroskolliniatis9352, Sorry to hear about your problem. At the very young age of 20, you should not be having aggressive skin treatments. It is possible to improve the health, and volume of the surviving facial fat, but I recommend you no longer have any thermal treatments until you are much older. You can refer to this video on how surviving fat can be improved - kzbin.info/www/bejne/q2exmJZ3n8qWfdE

[@stavroskolliniatis9352]

@AmiyaPrasadMD I also wanted to ask. I was prescribed tretnoine 0.04% for my acne but I was wondering if it's safe to start in your 20s and if it'll be alright for my skin in the longterm before I start

[@AmiyaPrasadMD]

Hi@@stavroskolliniatis9352, I hope you understand that without an examination of your skin like your doctor did, it's not my place to question their recommendation. I would have to see you in consultation to give you a proper second opinion. I hope this helps you.

[@iulianavasnic9514]

I for instance have destroyed part of the fat tissue in my cheeks due to tripollar radiofrequency. So I am thinking of either getting fillers or fat grafting. But i just don't trust any surgeon with fat grafting. I just can't find anywhere in the internet a good "after" photo for fat transfer to face. The end result either looks completely unnatural or it looks like you obviously had something done. With fillers at least you can check in the mirror every time the doctor injects a milliliter of hyaluronic acid so you can tell him/her where and how much more to inject after that. With fillers you can control the results: you can always interrupt the doctor and discuss with him/her where else to inject, with fat you have no control. However, that being said, i don't know how much hyaluronic acid you can inject at once in a cheek? Can you inject more than 10 ml? probably not... My cheeks need some reconstruction, so more than 10 ml is necessary. By the way my profile photo is not me, that is a picture of Shakira. But i honestly don't know any surgeon whose esthetic sense i can trust, if i knew one, i would definitely go for fat transfer...

[@AmiyaPrasadMD]

Hi Iuliana Vasnic, I completely agree with you that fat transfer is not ideal for facial volume loss because results are very unpredictable. 30-70% of grafted fat can be absorbed by the body soon after surgery, so it usually requires at least two fat transfer procedures. The amount of filler you can place in the cheeks depends on the technique you use to place filler. The dermal/fat/soft tissue space cannot hold as much filler. If filler is placed at the bone level, which is held in place by the muscle layer, you can place more filler, and it looks more natural. This filler technique is not used by most doctors, but you can refer to this technique which I call Structural Volumizing in these videos: kzbin.info/www/bejne/fZ2pY5iGm5Z0fdk kzbin.info/www/bejne/rHKYkqlrqq-Egqs kzbin.info/www/bejne/o5TVf4R9h9dmi5I kzbin.info/www/bejne/mXzSpXVtp82De80

[@iulianavasnic9514]

@@AmiyaPrasadMD thank you doctor Prasad :)

[@AmiyaPrasadMD]

You're welcome, @@iulianavasnic9514!